Is GI right that PPI’s unsafe for infant?

[Anonymous]

Hi, we’re new members and parents and we’ve found the site helpful.

Here’s our scoop. Our 4-week-old baby girl has reflux but has gained

weight ok, from 6-14 to 8-4. Our pediatrician prescribed 1mg Zantac 2

weeks ago. That’s helped some. Today, a pediatric GI prescribed a switch

to 1.2mg of Axid (another H2-blocker, but said to be better tolerated

because it lacks alcohol & tastes like bubblegum). Except in more serious

cases of reflux, this GI will not prescribe a PPI (like Prilosec or Prevacid) to

a baby under one year of age, because such use is not indicated on the

label as FDA-approved. We plan to give Axid a fair try, but reading the

posts on this website makes me wonder whether this GI is being too

conservative for our baby’s good. So…. here are our questions:

-How early have your babies been put on PPIs?

-Have you experienced any negative consequences?

-What are the potential concerns about giving an infant a PPI?

-Are any particular PPIs thought to be better or worse for infants?

-Can you point us to any preliminary research that either supports or

advises against the prescription of PPIs in infants, and at what age?

-Can you point us to any authorities who offer guidance on the age at

which babies may safely be prescribed PPIs?

Thanks for listening, and thanks so much for all your help! –M&S

[Anonymous]

Hi M&S and welcome.

I’m an Aussie so am not up with the whole FDA thing, but I’ll answer your questions from my expereince

How early have your babies been put on PPIs?

Alana was on a PPI at 12 weeks. This was about 4 weeks after her diagnsosis. I would have been happy to put her on earlier if needed.

-Have you experienced any negative consequences?

No, only positive, after a couple of weeks I had a new baby?

-What are the potential concerns about giving an infant a PPI?

I think like lots of meds there are not a lot of studies in infants. I think thats leads to concerns if there are long term effects.

-Are any particular PPIs thought to be better or worse for infants?

Not that I am aware of. There have been a variety of meds used by mums on this site…some have worked better than others for their bubs. This is probaly more a trial and error effect. Losec was terrible for Alana but Prevacid was fine.

-Can you point us to any preliminary research that either supports or
advises against the prescription of PPIs in infants, and at what age?

You can head to marci-kids.com for some info. Lori (S&H mum) would be a good source of info, hopefully she will post or try and PM her.

-Can you point us to any authorities who offer guidance on the age at which babies may safely be prescribed PPIs?

Sorry, not in the US, but I’m sure some of the others will post about this.

I think a lot of mums have come up against similar info from their peads and pead GI, which has resulted in many having to get a second or a third opinion. In my case it was my family dr who I got my second opinion from and who was able to support me in using a PPI.

I hope axid is the answer for you, as it is for some. But if it isn’t I hope you can find someone who supports a trial on a PPI.

[Anonymous]

Hi and welcome!!! I understand your concerns about PPI medicines but honestly I’m not sure that there are ANY medicines that are approved by the FDA for infants. Not many people, understandably, want to put their child through a drug study to test them out. Are zantac and axid approved? I am not even sure how to find that out…Anyway, here’s my input and I hope it helps.

-How early have your babies been put on PPIs?

Sarah was started on zantac at 2.5 weeks old and then compounded prevacid at 8 weeks. Neither did anything so we started zegerid, an immediate release PPI, at 4 months. I would have HAPPILY started the PPI sooner if I would have known it existed!

-Have you experienced any negative consequences?

ZERO negative consequences. I finally had a comfortable and happy baby. It was well worth it!

-What are the potential concerns about giving an infant a PPI?

There are always going to be concerns and worries over every new and different thing I do with Sarah (cause it’s a mom worry thing! ) Sure, I worry about what IF it’s not ok to be giving it to her…but the damage that could have been caused to her esophagus by the constant acid would have been bad too!

-Are any particular PPIs thought to be better or worse for infants?

I don’t think so. I just know that PPIs are not effective in infants if they are not prepared and dosed correctly. Again, check out marci-kids.com for tons of great information about different meds.

-Can you point us to any preliminary research that either supports or

advises against the prescription of PPIs in infants, and at what age?

Again, marci-kids has a lot of research and information about dosing PPIs in infants.

-Can you point us to any authorities who offer guidance on the age at
which babies may safely be prescribed PPIs?

Dr. Phillips from marci-kids has been a great resource for a lot of moms on this board and has often called family pediatricians and doctors to reassure them about dosing PPIs in infants.

I know how stressful and overwhelming it is to have a baby that is in constant pain. Untreated reflux can lead to feeding aversions, esophagus erosion, and misery for all involved! You have to weigh out your options and do what you feel comfortable with as a family. I think it’s great that you’re willing to research all options to find the best one. Good luck and please keep us posted! The moms on this board were able to provide a MILLION times more support and resource than Sarah’s doctor!!!!!!!

[Anonymous]

Hi and Welcome,

I agree with Amy in that I don’t think any drugs are approved for infants really. They use prevacid on neonates who are premies so I assume that are fine. My dh is a pharmacist and they use them all the time on his babies he cares for. We started Cooper on Zantac at 8wks and Prevacid at 10wks and have gradually upped the dose to where we are now. The only side effect we have seen is a happy baby. Good luck.

[Anonymous]

Hello and welcome,

Like the others have mentioned http://www.marci-kids.com would be a good source for you to investigate. They have studies listed that you can look at.

Very few meds are actually FDA approved for children under two because drug companies and parents generally don’t want to do studies on infants.

My first reflux baby was treated with Zantac and she continued to be miserable until she finally outgrew reflux at 9 months of age. It was a long, hard 9 months.

My second reflux baby was put on Prevacid at 4-5 months old. (I would have asked for it earlier if I had known about it sooner). He did great on Prevacid. No more pain. No more chronic irritabilty and feeding struggles. The only side effect I can attribute to Prevacid is constipation, but my son also had DGE so he was prone to constipation anyway. Also the solutabs contain lactose and aspartame which bother some babies’ tummies. My son had some cramping initially, but that passed within two weeks as his body adjusted to it.

As for better or worse PPI’s, it seems to be the consensus here that Prevacid and Zegerid both work very well for most babies. Both have their pros and cons. Prevacid (solutabs, capsules or packets) has to be timed around meals (given on an empty stomach and then followed up by a feeding 30 minutes later). This can be difficult with a small baby. Zegerid does not have to be timed around meals, but it has a high sodium content which causes some babies to throw it up. (I gave my son a few doses of it and he did not throw up even though he was a huge puker, so this doesn’t happen to all babies).

For any PPI it’s best to avoid the compounded versions (Prilosec or Compounded Prevacid) because they tend to be unstable unless they are prepared perfectly by the pharmacist, and they rarely are.

I hope that helps some.

[Anonymous]

Hi and welcome!

I’m glad you found this forum. It’s an incredible place to get information and support I just wanted to add my two cents by saying that my dd was put on a PPI at 6 weeks…maybe seven…I can’t remember. PPIs have worked wonders for so many kiddos here and I felt very safe using them with my daughter. I’m sorry I don’t have any research to back that up but like the other moms said, marci-kids.com is a great resource. Have you read the book ” Colic Solved”? It provides a wealth of information about reflux and allergies. Good luck, I hope your baby gets relief soon

[hellbennt]

Groupie Intro: my intro: https://www.infantreflux.org/forum/forum_posts.asp?TID=853&am p;PN=1&TPN=1

[Author]

Posts